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 睪丸結石與不孕 |
2014-09-09 |
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奇美醫院生殖醫學中心
聯合報 |
奇美醫院生殖醫學團隊研究發現，睪丸結石男性常合併精索靜脈曲張，精蟲活動力較差，會影響另一半的懷孕率。醫師提醒男性，超音波檢查如發現睪丸結石，應該定期回診。
林口長庚醫院泌尿科主治醫師黃世聰指出，從生理構造來看，睪丸應不會結石，睪丸結石是超音波影像學上的一種描述，便於醫病溝通，通常是指單側或雙側睪丸出現白點亮點，類似其他器官的結石。
奇美醫院生殖醫學科主治醫師蔡幸君在台灣生殖醫學會發表「睪丸結石對不孕男性精液品質之影響」，發現男性如有睪丸結石、精索靜脈曲張等問題，精蟲活動力和數目都較差。
研究人員分析去年至該院尋求不孕治療，且接受超音波的171名男性病患，有16人出現睪丸結石，其中4人沒有合併疾病。精液分析報告顯示，睪丸結石、精索靜脈區張的男性，確實屬於不孕高危險群，精蟲數目、活動力都比一般男性還差，直接影響臨床懷孕率
睪丸結石對不孕男性精液品質之影響
The influence of testicular microlithiasis to sperm quality in infertile male population
蔡幸君* 蔡永杰 康介乙 鍾明廷 林亮吟 陳姵君 黃宣綺 蘇詩雅
奇美醫療財團法人奇美醫院 婦產部
Hsing Chun Tsai*, Yung-Chieh Tsai, Chieh-Yi Kang, Ming-Ting Chung, Liang-Yin Lin, Irene Chen, Hsuan-Chi Huang, Shih-Ya Su,
Department of Obstetrics and Gynecology, Chi-Mei Medical Center
Objective:
To access the incidence of testicular microlithiasis in infertile male population and to investigate its influence to sperm quality.
Materials and Methods:
It was a retrospective study. There were total 171 male patients who presented to infertility clinic and received scrotal ultrasound due to suboptimal semen analysis, scrotal symptoms or previously diagnosed varicocele in Jan 2012 to Dec 2012. All scrotal ultrasound results and available comparable semen analysis data were reviewed.
Results:
Varicocele was the leading diagnosis of scrotal ultrasound and its incidence was 72.5% (124/171). There were 75 cases who had bilateral varicocele and 49 cases who had unilateral. Testicular microlithiasis was found in 16 cases and 12 cases among them had co-existing pathology of varicocele.
Only 4 cases had testicular microlithiasis alone. In these 171 cases, 86 comparable semen analysis results were available. According to the scrotal ultrasound, 55 cases had varicocele, 13 cases had microlithiasis, and 18 cases had neither varicocele nor microlithiasis (control group).
The results showed poorer sperm quality in both varicocele group and microlithiasis group compared with control. Besides, sperm concentration and motility were worst in microlithiasis group although there was no statistical difference.
Conclusions:
The incidence of testicular microlithiasis in infertile male population was 9.4% (16/171), and it was higher than expectation. Most of them had co-existing scrotal pathology. The sperm quality of microlithiasis group was the poorer than varicocele group and control group although there was no significant difference. The study numbers in this study was small, and further studies need to be carried out to determine the significance of this condition.
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